Acromial and scapular spine fractures after reverse shoulder arthroplasty

• Published in: Obere extremität Vol. 12; no. 1; pp. 32 - 37
• Main Authors: Ekelund, Anders L., Seebauer, Ludwig
• Format: Journal Article
• Language: English
• Published: Munich Springer Medizin 01.03.2017
• Subjects: Medicine; Medicine & Public Health; Orthopedics; Review Article; Surgical Orthopedics; Shoulder fractures; Arthroplastik; Skapula; Schulterfrakturen; Acromion; Arthroplasty; Scapula; Akromion; Postoperative complications; Postoperative Komplikationen
• ISSN: 1862-6599; 1862-6602
• DOI: 10.1007/s11678-016-0385-x

Background The reported incidence of postoperative fractures of the acromion or scapular spine after reverse shoulder arthroplasty is up to 7%. There is no consensus regarding treatment. Aims This article aims to review and summarize the current literature on postoperative fractures of the acromion or scapular spine. Results Postoperative fractures of the acromion or scapular spine can occur spontaneously or after trauma. Most of the fractures occur during the first postoperative year. The patient experiences sudden severe pain over the shoulder and inability to actively elevate the arm. The diagnosis is made from plain radiographs and CT scans. Treatment is nonoperative involving an abduction brace or open reduction and internal fixation. Although these fracture patients improve relative to their preoperative function, the results are inferior compared with those in patients without this complication. There are no comparative studies in the literature. Conclusion Postoperative fracture of the base of the acromion or the spine of the scapula is a common complication after reverse shoulder arthroplasty. It has a negative effect on functional outcome and is difficult to treat. Based on the published literature, no recommendation can be given regarding treatment. Further studies are needed.